Week 5; case work and case management

Question 1

what is the goal of case management?

Answer 1

There is a sense in which the effect of a large majority on an individual majority member has reached a plateau: additional members or ‘bits’ of majority influence have relatively little impact. Although a minority viewpoint has relatively little impact, it has not yet attained a plateau: additional members or ‘bits’ of minority influence have a relatively large impact. In this way, exposure to minority positions can, paradoxically, have greater impact than exposure to majority viewpoints.

Question 2

what are the four most widely recognised and used case management models?

Answer 2

Broker model
The Broker model is the traditional approach derived from social casework and is widely used in the AOD field. This approach is the least intensive model, involving minimal personal interaction between professional and individual client (Rapp et al. 2014). Key roles include assessing client needs, referring to other support agencies, coordinating services and monitoring treatment. Case management is brief, occurring over one or two sessions (Hesse et al. 2011).
Generalist model
Generalist case management provides the traditional functions of case management found in the broker model, but is usually characterised by a closer involvement of the professional in the client’s treatment.
Strengths-based model
This model provides the core case management functions but focuses on individuals’ strengths. This approach emphasises client-driven goal setting and assertive outreach. A greater focus of this case management approach is on informal support networks rather than professional services (Hesse et al., 2011).
Wraparound or Assertive Community Treatment (ACT) model
Wraparound case management is characterised by intense support where case management and treatment are combined. A multidisciplinary team shares responsibility for clients with low staff:client ratios (McDonald, 2005). This approach is often used with comorbid individuals (Rapp et al., 2014).

Question 3

what considerations are important for effective case work to be successful?

Answer 3

Social work thinking

places an emphasis on acknowledging the person-in-their-environment (Fook 1993). To successfully understand the strengths people have and the challenges they confront, their internal and external worlds have significance. Casework, which is primarily a psychosocial approach, attends to both the psychological issues that impact on people, and the structural and social worlds in which they live. To use an example, for someone who has experienced inter-generational poverty and is substance dependent, a casework approach would consider the impact of the substance use on this person’s life – why they use, how this makes them feel, what contributes to times of less/more use, etc. Also of importance may be the familial and social structures that have contributed to their experience of poverty and how this has influenced their substance use history.

Organisational policies-

Organisational policies and procedures set the context in which the casework service operates. As an employee, caseworkers should be aware of the statutory and legislative frameworks that affect their work and the accountability structures within their agencies. Any credible casework service will require appropriate documentation. Caseworkers may be required to keep contact summaries and record case notes. How this is done will depend on the agency and nature of the service being offered.

Working relationship formed and care plan developed

All casework takes place within the context of a working relationship. In many cases this relationship will develop with an individual but casework services are routinely provided for couples, families and groups.

Caseworkers and clients establish a contract, termed a care plan that specifies actions and allocated tasks of each. The care plan formalises the casework process and function as an accountability measure.

A Care Plan should be explicit regarding:

Action to be undertaken
How and where it will be undertaken
Timeframes
Who is involved and what responsibilities they hold

Question 4

what is the underpinning knowledge required for effective casework?

Answer 4

In every case, a person’s unique circumstances need to be taken into account. Clients with AOD issues come from a full range of backgrounds and age groups. They may also have a range of co-existing and related issues to face.

Agencies and caseworkers have a responsibility to ensure that their practice is relevant and useful for these groups. When working with clients with AOD issues, it is important that workers have a good understanding of the treatment or options available and how the service system works.

The AOD service system has a range of options for treatment which include: Counselling, Outreach, Home Based Withdrawal; Outpatient withdrawal; Peer Support/Self Help Programs; Telephone counselling; Community Residential Withdrawal Services, Private Hospital withdrawal services; Therapeutic/Rehabilitation Programs, AOD supported accommodation programs, Accident and Emergency and Pharmacotherapies.

Given the diverse range of organisations providing these various treatment options in Australia, there will be differences in the way the service is provided from organisation to organisation.

Question 5

What are the C.O.R.E Model -features of an effective casework approach?

Answer 5

(C) Clarity
The nature of the relationship that the worker and client are entering needs to be defined and clearly understood. This includes the intention of the worker and their level of involvement, confidentiality arrangements and any statutory obligations. This information must be shared with other stakeholders, particularly family members.

Appropriate boundaries need to be established, discussed and maintained.

(O) Open communication and trust
Establish a climate where the client feels free to engage in an open and honest exchange of information

Workers who remain calm, hopeful and confident throughout the casework process will reassure clients and make themselves easy to trust

Make every effort to listen to the client and express interest in their situation. Assessment will be most effective when this interest is genuine

(R) Respect and care
Provide the client with a clear expression of care and support

Respect the client’s right to make choices, take risks and make mistakes

Endeavour to make decisions with the client not for them

(E) Engagement and consistency of presence
Engagement occurs at the same time as casework tasks are being completed (e.g. during assessment).

Be approachable and friendly.

Remain open at all times and avoid taking control over the process.

Be a reliable option for the client, celebrating successes but most importantly being there for them when things are not working as planned.